Role of N-Terminal Pro-Brain Natriuretic Peptide and Cystatin C to Estimate Renal Function in Patients With and Without Heart Failure

Linzbach, Sven; Samigullin, Azat; Yilmaz, Sezai; Tsioga, Maria; Zeiher, Andreas M.; Spyridopoulos, Ioakim

doi:10.1016/j.amjcard.2009.01.009

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…18 In addition, Cys seems to reflect hemodynamic changes or myocardial damage. 11,19 In the present study, we found a clear correlation between Cys level and cardiac events in patients with a history of HF admission. The mechanism that allows UA and Cys to predict future cardiovascular events has been recently evaluated.…”

Section: Discussionsupporting

confidence: 66%

“…On the contrary, Cys levels may be increased by arterisoclerosis lesion or aging, although these factors have not been conclusively proven 18 . In addition, Cys seems to reflect hemodynamic changes or myocardial damage 11,19 . In the present study, we found a clear correlation between Cys level and cardiac events in patients with a history of HF admission.…”

Section: Discussioncontrasting

confidence: 64%

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Potentials of Cystatin C and Uric Acid for Predicting Prognosis of Heart Failure

Kim

Yoon

Park

et al. 2012

Congestive Heart Failure

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Few studies have explored the clinical potentials of combined Cystatin C (Cys) and uric acid (UA) in heart failure (HF). The authors evaluated Cys and UA as predictors of clinical outcomes compared with conventional renal biomarkers. This prospective cohort study included 587 HF patients presenting with dyspnea. At admission, Cys, UA, and other renal measures including serum urea nitrogen (BUN), creatinine (Cr), and glomerular filtration rate (GFR) were obtained. The primary endpoint was the composite of cardiac death and rehospitalization for worsening HF. During a 25‐month median follow‐up period, 68 patients experienced clinical outcomes: 9 cardiac deaths and 59 HFs. They showed higher BUN and Cr values and lower GFR. Within these parameters, Cys and UA had the most favorable area under the curves, and patients with Cys ≥0.8 mg/L and UA ≥6.6 mg/dL showed more frequent events. The net reclassification improvement analysis showed the combination of Cys and UA had a greater incremental effect for cardiac prognosis. On multivariate Cox hazard analysis, Cys and UA were independent predictive markers for clinical outcomes. In HF patients presenting with dyspnea, Cys and UA appear to be more useful predictors of clinical events than other renal measures.

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Section: Discussionsupporting

confidence: 66%

Section: Discussioncontrasting

confidence: 64%

Potentials of Cystatin C and Uric Acid for Predicting Prognosis of Heart Failure

Kim

Yoon

Park

et al. 2012

Congestive Heart Failure

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“…It makes sense that NT-proBNP is associated with the development of AKI. The clinical application of serum NT-proBNP in cardiac disease has been extensively confirmed and finds its predictive value for AKI development in patients with HF, coronary angiography or percutaneous coronary intervention 19 23 44 45. Several studies have elucidated the link between NT-proBNP and AKI incidence after cardiac or non-cardiac surgery 13 46–48.…”

Section: Discussionmentioning

confidence: 99%

“…Although serum NT-proBNP and sCysC are mainly used for the prognosis assessment of heart disease and the prediction of acute cardiac events with AKI,22–26 the diagnostic accuracy of their combination for AKI in ICU remains unknown. We performed a prospective study in the present research to evaluate the performance of serum NT-proBNP and sCysC at ICU admission, both independently and in combination, for AKI determination among critically ill adults.…”

Section: Introductionmentioning

confidence: 99%

Serum N-terminal pro-B-type natriuretic peptide and cystatin C for acute kidney injury detection in critically ill adults in China: a prospective, observational study

Deng

Liang

et al. 2023

BMJ Open

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ObjectiveSerum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (sCysC) are available clinically and beneficial in diagnosing acute kidney injury (AKI). Our purpose is to identify the performance of their combined diagnosis for AKI in critically ill patients.DesignA prospectively recruited, observational study was performed.SettingAdults admitted to the intensive care unit of a tertiary hospital in China.ParticipantsA total of 1222 critically ill patients were enrolled in the study.Main outcome measuresTo identify the performance of the combined diagnosis of serum NT-proBNP and sCysC for AKI in critically ill patients. The area under the receiver operating characteristic curve (AUC-ROC), category-free net reclassification index (NRI) and incremental discrimination improvement (IDI) were utilised for comparing the discriminative powers of a combined and single biomarker adjusted model of clinical variables enriched with NT-proBNP and sCysC for AKI.ResultsAKI was detected in 256 out of 1222 included patients (20.9%). AUC-ROC for NT-proBNP and sCysC to detect AKI had a significantly higher accuracy than any individual biomarker (p<0.05). After multivariate adjustment, a level of serum NT-proBNP ≥204 pg/mL was associated with 3.5-fold higher odds for AKI compared with those below the cut-off value. Similar results were obtained for sCysC levels (p<0.001). To detect AKI, adding NT-proBNP and sCysC to a clinical model further increased the AUC-ROC to 0.859 beyond that of the clinical model with or without sCysC (p<0.05). Moreover, the addition of these two to the clinical model significantly improved risk reclassification of AKI beyond that of the clinical model alone or with single biomarker (p<0.05), as measured by NRI and IDI.ConclusionsIn critically ill individuals, serum NT-proBNP, sCysC and clinical risk factors combination improve the discriminative power for diagnosing AKI.

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“…Недавно было показано, что цистатин С крови является независимым предиктором смертности, трансплантации сердца и госпитализаций по поводу СН [167]. Была выявлена взаимосвязь цистатина С крови с повреждением миокарда, уровнем NT-pro-BNP и дисфункцией желудочков [107,108,113,167]. Взаимосвязи уровня цистатина С с продолжительностью госпитализаций у больных с ИБС, ХСН и ОСН не выявлено [53].…”

Section: новые биомаркеры функции и повреждения почекunclassified

Cardiorenal Syndrome in Patients With Chronic Heart Failure as a Stage of the Cardiorenal Continuum (Part I): Definition, Classification, Pathogenesis, Diagnosis, Epidemiology

Резник

Никитин

2019

Arhivʺ vnutrennej mediciny

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The combination of heart failure and renal failure is called cardiorenal syndrome. It is a stage of the cardiorenal continuum and, possibly, a small link of the cardiorenal-cerebral-metabolic axis. Despite the fact that the phrase “cardiorenal syndrome” and its five types have become a part of the medical lexicon, many aspects of this problem are still not clear. Cardiorenal syndrome can be diagnosed in 32-90.3% of patients with heart failure. Cardiorenal syndrome type 1 or 2 develops in most cases of heart failure: cardiorenal syndrome presents with the development ofchronic kidney disease in patients with chronic heart failure and acute kidney injury in patients with acute heart failure. Impaired renal function has an unfavorable prognostic value. It leads to an increase in the mortality of patients with heart failure. It is necessary to timely diagnose the presence of cardiorenal syndrome and take into account its presence when managing patients with heart failure. Further researches are needed on ways toprevent the development and prevent the progression of kidney damage in patients with heart failure, to which the efforts of the multidisciplinary team should be directed. The first part of this review examines the currently definition, classification, pathogenesis, epidemiology and prognosis of cardiorenal syndrome in patients with heart failure.

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Role of N-Terminal Pro-Brain Natriuretic Peptide and Cystatin C to Estimate Renal Function in Patients With and Without Heart Failure

Cited by 6 publications

References 27 publications

Potentials of Cystatin C and Uric Acid for Predicting Prognosis of Heart Failure

Potentials of Cystatin C and Uric Acid for Predicting Prognosis of Heart Failure

Serum N-terminal pro-B-type natriuretic peptide and cystatin C for acute kidney injury detection in critically ill adults in China: a prospective, observational study

Cardiorenal Syndrome in Patients With Chronic Heart Failure as a Stage of the Cardiorenal Continuum (Part I): Definition, Classification, Pathogenesis, Diagnosis, Epidemiology

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